The association between length of stay in the emergency department and short-term mortality
Wessman, Torgny LU ; Ärnlöv, Johan ; Carlsson, Axel Carl ; Ekelund, Ulf LU
; Wändell, Per
LU
; Melander, Olle
LU
and Ruge, Toralph
LU
(2022)
In Internal and Emergency Medicine
17(1).
p.233-240
- Abstract
The detrimental effects of increased length of stay at the emergency department (ED-LOS) for patient outcome have been sparsely studied in the Swedish setting. Our aim was to further explore the association between ED-LOS and short-term mortality in patients admitted to the EDs of two large University hospitals in Sweden. All adult patients (> 18 years) visiting the ED at the Karolinska University Hospital, Sweden, from 1/1/2010 to 1/1/2015 (n = 639,385) were retrospectively included. Logistic regression analysis was used to determine association between ED-LOS and 7- and 30-day mortality rates. All patients were triaged according to the RETTS-A into different levels of medical urgency and subsequently separated into five quintiles... (More)
The detrimental effects of increased length of stay at the emergency department (ED-LOS) for patient outcome have been sparsely studied in the Swedish setting. Our aim was to further explore the association between ED-LOS and short-term mortality in patients admitted to the EDs of two large University hospitals in Sweden. All adult patients (> 18 years) visiting the ED at the Karolinska University Hospital, Sweden, from 1/1/2010 to 1/1/2015 (n = 639,385) were retrospectively included. Logistic regression analysis was used to determine association between ED-LOS and 7- and 30-day mortality rates. All patients were triaged according to the RETTS-A into different levels of medical urgency and subsequently separated into five quintiles of ED-LOS. Mortality rate was highest in highest triage priority level (7-day mortality 5.24%, and 30-day mortality 9.44%), and decreased by lower triage priority group. For patients with triage priority levels 2–4, prolonged ED-LOS was associated with increased mortality, especially for lowest priority level, OR for priority level 4 and highest quintile of ED-LOS 30-day mortality 1.49 (CI 95% 1.20–1.85). For patients with highest triage priority level the opposite was at hand, with decreasing mortality risk with increasing quintile of ED-LOS for 7-day mortality, and lower mortality for the two highest quintile of ED-LOS for 30-day mortality. In patients not admitted to in-hospital care higher ED-LOS was associated with higher mortality. Our data suggest that increased ED-LOS could be associated with slightly increased short-term mortality in patients with lower clinical urgency and dismissed from the ED.
(Less)
- author
- Wessman, Torgny
LU
; Ärnlöv, Johan
; Carlsson, Axel Carl
; Ekelund, Ulf
LU
; Wändell, Per
LU
; Melander, Olle
LU
and Ruge, Toralph
LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Elderly, Emergency department crowding, Emergency department length of stay, Emergency medicine, Emergency room, Epidemiology, Mortality rate
- in
- Internal and Emergency Medicine
- volume
- 17
- issue
- 1
- pages
- 233 - 240
- publisher
- Springer
- external identifiers
-
- pmid:34110561
- scopus:85107470388
- ISSN
- 1828-0447
- DOI
- 10.1007/s11739-021-02783-z
- language
- English
- LU publication?
- yes
- id
- bb754c2c-4ab6-4e07-a063-14d80ff4bbe8
- date added to LUP
- 2021-07-09 14:35:07
- date last changed
- 2025-03-09 15:01:10
@article{bb754c2c-4ab6-4e07-a063-14d80ff4bbe8,
abstract = {{<p>The detrimental effects of increased length of stay at the emergency department (ED-LOS) for patient outcome have been sparsely studied in the Swedish setting. Our aim was to further explore the association between ED-LOS and short-term mortality in patients admitted to the EDs of two large University hospitals in Sweden. All adult patients (> 18 years) visiting the ED at the Karolinska University Hospital, Sweden, from 1/1/2010 to 1/1/2015 (n = 639,385) were retrospectively included. Logistic regression analysis was used to determine association between ED-LOS and 7- and 30-day mortality rates. All patients were triaged according to the RETTS-A into different levels of medical urgency and subsequently separated into five quintiles of ED-LOS. Mortality rate was highest in highest triage priority level (7-day mortality 5.24%, and 30-day mortality 9.44%), and decreased by lower triage priority group. For patients with triage priority levels 2–4, prolonged ED-LOS was associated with increased mortality, especially for lowest priority level, OR for priority level 4 and highest quintile of ED-LOS 30-day mortality 1.49 (CI 95% 1.20–1.85). For patients with highest triage priority level the opposite was at hand, with decreasing mortality risk with increasing quintile of ED-LOS for 7-day mortality, and lower mortality for the two highest quintile of ED-LOS for 30-day mortality. In patients not admitted to in-hospital care higher ED-LOS was associated with higher mortality. Our data suggest that increased ED-LOS could be associated with slightly increased short-term mortality in patients with lower clinical urgency and dismissed from the ED.</p>}},
author = {{Wessman, Torgny and Ärnlöv, Johan and Carlsson, Axel Carl and Ekelund, Ulf and Wändell, Per and Melander, Olle and Ruge, Toralph}},
issn = {{1828-0447}},
keywords = {{Elderly; Emergency department crowding; Emergency department length of stay; Emergency medicine; Emergency room; Epidemiology; Mortality rate}},
language = {{eng}},
number = {{1}},
pages = {{233--240}},
publisher = {{Springer}},
series = {{Internal and Emergency Medicine}},
title = {{The association between length of stay in the emergency department and short-term mortality}},
url = {{http://dx.doi.org/10.1007/s11739-021-02783-z}},
doi = {{10.1007/s11739-021-02783-z}},
volume = {{17}},
year = {{2022}},
}